One of the earliest events preceding several forms of retinal degeneration is the formation and accumulation of vitamin A dimers in the retinal pigment epithelium (RPE) and underlying Bruch’s membrane (BM). Such degenerations include Stargardt disease, Best disease, forms of retinitis pigmentosa, and age-related macular degeneration (AMD). Since their discovery in the 1990’s, dimers of vitamin A, have been postulated as chemical triggers driving retinal senescence and degeneration. There is evidence to suggest that the rate at which vitamin A dimerizes and the eye’s response to the dimerization products may dictate the retina’s lifespan. Here, we present outstanding questions, finding the answers to which may help to elucidate the role of vitamin A dimerization in retinal degeneration.
Stargardt Age-related macular degeneration AMD ABCA4 RPE Vitamin A Retinaldehyde Bisretinoids Vitamin A dimer A2E Lipofuscin Fundus autofluorescence Visual cycle
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We thank the U.S. National Institutes of Health (1R01EY021207 and 5P30EY019007) and Research to Prevent Blindness (RPB) Inc., New York.
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